DESCRIPTION: The long-term objective of this study is to develop cost-effective, community based strategies for the prevention of falls in high-risk elderly women. Specific aims are to test the efficacy of a fall prevention program for high risk elderly women, determine the effects of the fall prevention program on postural competence, functional performance, mood, health-related quality of life, and fear of falling and fall-related injuries, health service utilization and costs; and identify demographic, clinical, personal, functional, and postural competence variables that predict long term exercise adherence. A randomized, controlled, single-blinded trial with two groups: a) a fall prevention program (moderate intensity exercise, long-term exercise adherence interventions including an automated, interactive telephone system, and tailored fall risk reduction education) and b) a control group (health education). The probability sample will consist of 250 community dwelling women who are: 70 years and over, mentally intact, ambulatory, with postural instability and at least on other fall risk factor, not currently involved in regular exercise, medically stable with physician approval for independent exercise participation, able to understand and read English, and have a telephone. Both groups will receive a 12-week home-based intervention with alternative biweekly visits and telephone calls. Participants in the fall prevention program will receive an additional 16-week adherence intervention involving an automated, voice response, interactive telephone system for exercise prompting based on the Transtheoretical Model of Behavior Change. Data will be collected at baseline, at 12 weeks, and 1- and 2-years post treatment. The study will provide information on the efficacy and cost of simple interventions designed to prevent falls and fall-related injuries, reduce preclinical disability, maintain long-term exercise adherence, and improve life quality of older women.